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2014, Number 2

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Revista Cubana de Ortopedia y Traumatología 2014; 28 (2)

Madelung’s deformity, apropos of a case series

Vergara-Amador E, Dávalos HDA

Language: Spanish
References: 29
Page: 153-167
PDF size: 409.21 Kb.


ABSTRACT

Introduction: Madelung deformity is due to a growth disturbance of distal radius physis. It can cause pain and loss of function.
Objectives: to review the current status of this disease and the results of a series of patients who received surgical treatment.
Methods: this is a case series of patients (12 patients) collected from 2005 to 2012, which were treated in hand surgery consultation. Radio osteotomy plate or guardian ulna osteotomy (shortening and angular correction) and distal resection of the ulna (Darrach) were the surgical procedures used. Mobility variables, radiology, and surgery satisfaction were studied. Ulnar inclination and the lunate tilt radiological data were analyzed; also a qualitative analysis of the correction of the ulna was conducted.
Results: in the 8 patients operated (11 wrists: 9 angle correction by osteotomy of the radius, and 2 with tutor), the aesthetic results were good. In terms of function, all mobility parameters improved. In the 7 cases of wrist where Darrach was performed, the dorsal aspect of the wrist improved. After a short time, no ulnar translation of the carpus was observed. The radiographic appearance markedly improved: the ulnar inclination changed from preoperative 37º to postoperative 28º and the lunate fossa angle changed from 55° to 36°, respectively.
Conclusions: the smallness of the series and the short follow-up time is a limitation of this study, although it is shown that with the right combination of some surgical techniques aesthetic and functional improvements in Madelung deformity can be achieved.


REFERENCES

  1. Anton J, Reitz G, Spiegel M. Madelung's Deformity. Ann Surg. 1938;108(3):411-39.

  2. Arenas A, Ayala H, Garbayo A. Tratamiento Quirúrgico de la Deformidad de Madelung. Rev Esp Cir Ost. 2004;39(219):132-44.

  3. Angelini LC, Leite VM, Faloppa F. Surgical treatment of Madelung disease by the Sauve-Kapandji technique. Ann Chir Main Memb Super. 1996;15(4):257-64.

  4. Zebala L, Manske P, Goldfarb C. Madelung’s Deformity: A Spectrum of Presentation. J Hand Surg Am. 2007;32:1393-401.

  5. Brooks TJ. Madelung Deformity in a Collegiate - Gymnast: A Case Report. J Athl Train. 2001;36(2):170-3.

  6. Arora A, Chung K, Otto W. Madelung and the Recognition of Madelung’s Deformity. J Hand Surg Am. 2006;31(2):177–82.

  7. Dos Reis F, Katchburian M, Faloppa F, Albertoni W, Laredo Filho J. Osteotomy of the radius and ulna for the Madelung deformity. J Bone Joint Surg Br. 1998;80(5):817-24.

  8. Bhat M, Chetan R, Shivashankar K, Jayaram M. Madelung Deformity—the Hallmark of Dyschondrosteosis. Indian Pediatr. 1995;32(12):1314-6.

  9. Vickers D, Nielsen G. Madelung Deformity: Surgical prophylaxis (physiolysis) during the late growth period by resection of the dyschondrosteosis lesion. J Hand Surg Br. 1992;17(4):401-7.

  10. Ranawat CS, DeFiore J, Straub LR. Madelung’s deformity: An end-result study of surgical treatment. J BoneJointSurg Am. 1975;57(6):772-5.

  11. Henry A, Thorburn M. Madelung Deformity - A Clinical and Cytogenetic Study. J Bone Joint Surg Br. 1967;49(1):66-73.

  12. Clement-Jones M, Schiller S, Rao E, Blaschke RJ, Zuniga A, Zeller R, et al. The short stature homeobox gene SHOX is involved in skeletal abnormalities in Turner syndrome. Hum Mol Genet. 2000;9:695-702.

  13. Blanco ME, Pérez-Cabrera A, Kofman-Alfaro S, Zenteno JC. Clinical and Cytogenetic Findings in 14 Patients WithMadelung Anomaly. Orthopedics. 2005;28(3):315-9.

  14. Velán O, Tarzián C, Fustiñana C. Discondrosteosis. Hospital Italiano de Buenos Aires. Rev. argent. radiol. 2008;72(3):297-9.

  15. McCarroll HR Jr, James MA, Newmeyer WL 3rd, Molitor F, Manske PR. Madelung’s deformity: quantitative assessment of x-ray deformity. J Hand Surg Am. 2005;30:1211–20.

  16. Harley B, Carter P, Ezaki M. Volar surgical correction of Madelung’s deformity. Tech Hand Upper Extremity Surg. 2002;6:30–5.

  17. McCarroll HR Jr, James MA, Newmeyer WL 3rd, Manske P. Madelung’s Deformity: Diagnostic Thresholds of Radiographic Measurements. J Hand Surg Am. 2010;35:807–12

  18. Tuder D, Frome B, Green DP. Radiographic Spectrum of severity in Madelung’s Deformity. J Hand Surg Am. 2008;33(6):900–4.

  19. Ghatan A, Hanel D. Madelung deformity. J Am AcadOrthop Surg. 2013;21:372-82.

  20. Dagrégorio G, Saint-Cast Y. Reorientation of the distal radial articular surface in Madelung’s deformity by a reversed cuneiform osteotomy. Chir Main. 2005;24(2):109-12.

  21. Goodwin D, Michels C, Weissman S. Spontaneous rupture of extensor tendons in Madelung’s deformity. Hand. 1979;11(1):72-5.

  22. Fagg P. Wrist pain in the Madelung’s deformity of dyschondrosteosis. J Hand Surg Br. 1988;13(1):11-5.

  23. Álvarez Cambras R, Bernal González M de J, Cabrera Viltres N. La minifijaciónósea externa en las malformaciones congénitas. Rev Cubana Ortop Traumatol. 2000;14(1- 2):102-7.

  24. Ogino T, Ishigaki D, Satake H, Iba K. Free Fat Graft for Congenital Hand differences. ClinOrthop Surg. 2012;4(1):45-57.

  25. Aharoni C, Glard Y, Launay F, Gay A, Legré R. Madelung deformity: isolated ulnar wedge osteotomy. Chir Main. 2006;25(6):309-14.

  26. Rodríguez NJ, Suárez F, Bocanegra S, García A. Procedimiento de Sauvé-Kapandji modificado para desordenes postraumáticos y degenerativos de la articulaciónradioulnar distal. Rev Col de Or Tra. 2005;19(3):65-9.

  27. De Smet L, Fabry G. Treatment of Madelung’s deformity by Kapandji’s procedure and osteotomy of the radius. J PediatrOrthop B. 1993;2:96-8.

  28. Ranawat C, DeFiore J, Straub L. Madelung’s deformity: An end-result study of surgical treatment. J Bone Joint Surg Am. 1975;57(6):772-5.

  29. Harley B, Brown C, Cummings K, Carter P, Ezaki M. Volar Ligament Release and Distal Radius Dome Osteotomy for Correction of Madelung’s Deformity. J Hand Surg Am . 2006 Nov;31(9):1499-506.




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